The following are notes I took this morning on a presentation on health care fraud titled "Lifting the veil: The Citizens Federation’s discoveries of financial mischief by insurance executives and regulators". It was given by Buddy Robinson of the Citizens Federation at the Lake Superior Freethinkers meeting.
His talk was based on "Who Is Minding the Store", a report by the Citizens Federation.
Added up numbers and found that non-profits took profits. Put into reserves which became excessive – twice the safe amount and four times the required amount.
Reserves went into investments which in turn increased reserves. Insurance companies didn't report this to Minnesota legislature.
Several Minnesota counties are dealing directly with the state for employees' health care. Some are now considering opening to public.
Strange things found about financial reporting. CEO compensation reported at half actual - Health Partners
Money from state increased at greater rate than payments to providers.
Overpayment reimbursement not in contracts but if fraud involved then overpayments can be recovered.
Insurance companies don't want to divulge payments to providers.
State allowed companies to police themselves.
Motivation? Medica contracts with former parent UHC, giving it 2/3 of income.
Insurance companies use government money to subsidize commercial policy losses.
Private insurance was to save money; it wound up costing a lot more.
Are HMOs too big to fail or jail?
End of my meeting notes.
So much for the efficiency of private enterprise. Efficiency (sometimes) in lining corporate management pockets!
I gave as my comment Adam Smith's "The proposal of any new law or regulation of commerce which comes from this order…" See "The Invisible Adam Smith".
